Pharyngeal, Neck and Facial Infections: Deep Neck Infections Non Pharyngeal - Iatrogenic Origin

History

Possible iatrogenic or other non-pharyngeal origin infrahyoid neck infectious or inflammatory conditions including suppurative cervical lymphadenitis and infected developmental cysts leading to abscess or primary or secondary thrombophlebitis, arteritis or other complications involving the infrahyoid deep neck structures. Possible discitis, epidural abscess or prevertebral musculotendonitis.

Exam

Contrast-enhanced CT of the maxillofacial region and neck and related anatomy with images obtained in the balanced or venous vascular phase to ensure optimal visualization of both arterial and venous structures as well as possible reactive changes around infected collections. 0.5-3.0 mm thick sections were obtained in the axial plane and reformatted 3D and/or in the coronal and sagittal planes and viewed inter actively in 3 dimensions at the computer work station.

MR: Anatomically focused axial and coronal images through the face and neck region including T1 and T2 weighted acquisitions done with and without gadolinium contrast enhancement and, when indicated, MRV and fat suppression.

Findings

General

There is general or localized soft tissue swelling of the superficial or deep neck soft tissues. [Yes/No]

There is gas in the soft tissues. [Yes/No]

There is foreign body separate from or in areas of soft tissue swelling. [Yes/No]

Nasopharynx Including Retropharyngeal Lymph Nodes

There is edema/abscess or likely suppurative retropharyngeal adenitis involving the nasopharynx or adjacent deep tissue spaces. [Yes/No]

Oropharynx

There is edema/abscess tonsillar or otherwise or likely suppurative retropharyngeal adenitis involving the oropharynx or adjacent deep tissue spaces. [Yes/No]

Oral Cavity, Floor of the Mouth, Maxilla and Mandible

There is edema/abscess within or surrounding the buccal space, masticator space, floor of the mouth, submandibular space or the adjacent superficial fascia or subcutaneous fat and skin. [Yes/No]

Major Salivary Glands

The parotid, submandibular and sublingual glands are enlarged. [Yes/No]

The parotid, submandibular and sublingual glands do show abnormal enhancement. [Yes/No]

Hypopharynx, Larynx, Deep Neck and Entire Retropharyngeal Space

There is edema/abscess arising from the hypopharynx, larynx, thyroid gland or trachea. [Yes/No]

There is edema/abscess within the adjacent deep neck, and/or retropharyngeal space. [Yes/No]

There is evidence of a branchial or other origin inflamed/ infected developmental cyst. [Yes/No]

Prevertebral and Epidural Spaces

There is edema/abscess within in the prevertebral or paravertebral spaces. [Yes/No]

There is edema/abscess within in the epidural space. [Yes/No]

There is erosive process involving the disc spaces or other components of the spine. [Yes/No]

Cervical Lymph Nodes

There is reactive cervical lymphadenopathy. [Yes/No]

There is suppurative cervical lymphadenopathy. [Yes/No]

If there is suppurative cervical adenopathy the purulent material outside the lymph node(s) capsule(s). [Yes/No]

Vascular Findings

There is evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the jugular vein or smaller venous tributaries. [Yes/No]

There is evidence of thrombus, inflammation of the common, external or internal carotid artery. [Yes/No]

There is evidence of a contained leakage from an arterial source. [Yes/No]

There is evidence of active extravasation from an arterial or venous source. [Yes/No]

Upper lung zones and mediastinum

The upper lung zones and mediastinum visualized are abnormal. [Yes/No]

Other

Other significant abnormal findings are present. [Yes/No]

Impression

Deep Neck Infections Non Pharyngeal - Iatrogenic Origin

Deep neck cellulitis [with/without] abscess.
Suppurative lymphadenitis
Infected developmental cyst.
Retropharyngeal cellulitis [with/without] abscess.
Prevertebral abscess, discitis and/or epidural abscess.
Prevertebral musculotendonitis
Acute or subacute thyroiditis
Other facial or neck inflammation or infection [with/without] abscess possibly iatrogenic.
Venous thrombosis or thrombophlebitis
Arteritis or arterial injury